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Organization
MENTAL HEALTH SERVICES-ERIE COUNTY NORTHWEST CORPORATION I
Active
Organization
MENTAL HEALTH SERVICES-ERIE COUNTY NORTHWEST CORPORATION I
Active
Other names
Envision Wellness WNY Behavioral Health
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DANIEL CHURCH MBA (FINANCE DIRECTOR)
(716) 882-2127
Entity
Organization
Contact information
Practice address
2495 ELMWOOD AVE, KENMORE, NY 14217-2222
(716) 882-2127
(716) 882-9277
Mailing address
PO BOX 710, KENMORE, NY 14217-0710
(716) 882-2127
(716) 882-9277
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01556472
—
NY
05
—
02996876
—
NY
Enumeration date
03/20/2007
Last updated
01/31/2022
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